Melissa Sample, FNP in Chiloquin, OR - Medicare Nurse Practitioner

Melissa Sample, FNP is a medicare enrolled "Nurse Practitioner - Family" in Chiloquin, Oregon. She graduated from nursing school in 2008 and has 16 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Icco Llc and her current practice location is 103 Waso, Chiloquin, Oregon. You can reach out to her office (for appointments etc.) via phone at (541) 880-2011.

Melissa Sample is licensed to practice in Oregon (license number 200850150NP) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1922250364.

Contact Information

	Melissa Sample, FNP
	103 Waso, Chiloquin, OR 97624
	(541) 880-2011
	(541) 783-3273

Map and Direction

Provider's Profile

Full Name	Melissa Sample
Gender	Female
Speciality	Nurse Practitioner
Experience	16 Years
Location	103 Waso, Chiloquin, Oregon
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Melissa Sample graduated from nursing school in 2008

NPI Data:

NPI Number: 1922250364
Provider Enumeration Date: 10/16/2008
Last Update Date: 01/15/2015

Medicare PECOS Information:

PECOS PAC ID: 4183760424
Enrollment ID: I20090930000264

Medical Identifiers

Medical identifiers for Melissa Sample such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1922250364	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	099000635RN (Oregon)	Secondary
363LF0000X	Nurse Practitioner - Family	200850150NP (Oregon)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Sky Lakes Medical Center	Klamath falls, OR	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Icco Llc	1355406729	105

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Melissa Sample allows following entities to bill medicare on her behalf.

Entity Name	Sky Lakes Medical Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1659340370 PECOS PAC ID: 1052204096 Enrollment ID: O20040204000577

Entity Name	Icco Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407004757 PECOS PAC ID: 1355406729 Enrollment ID: O20090218000510

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Melissa Sample is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Melissa Sample, FNP 2074 S 6th St, Klamath Falls, OR 97601-3372 Ph: (541) 880-2011	Melissa Sample, FNP 103 Waso, Chiloquin, OR 97624 Ph: (541) 880-2011

Reviews and Comments

Nurse Practitioner Nurses in Chiloquin, OR

Cora Frantz, FNP-C, DNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 330 S Chiloquin Blvd, Chiloquin, OR 97624 Phone: 541-882-1487
Mrs. Anjanette Michelle Devine, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 330 S Chiloquin Blvd, Chiloquin, OR 97624 Phone: 541-882-1487 Fax: 541-783-3273
Andrew J Hughes, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 330 Chiloquin Blvd, Chiloquin, OR 97624 Phone: 800-246-7894 Fax: 541-783-2028
Ms. Elizabeth Burton Matuk, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 330 S Chiloquin Blvd, Chiloquin, OR 97624 Phone: 541-783-3293 Fax: 541-783-3273
Christina M Hughes, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 330 Chiloquin Blvd, Chiloquin, OR 97624 Phone: 800-246-7894 Fax: 541-783-2028
Crystal Nathalia Novelozo, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 330 Chiloquin Blvd, Chiloquin, OR 97624 Phone: 541-882-1487 Fax: 541-783-3237

Melissa Sample, FNP - Medicare Nurse Practitioner in Chiloquin, OR